Technology has simplified our lives both in and outside of the office environment. On any given day, it’s not unusual to see co-workers hunched over laptops or cell phones. Others frantically work non-stop at a desk. These gestures each take a toll on our bodies, which was designed to move. A daily routine of stretching in the office can keep the back, spine and neck in good working order. It’s important to maintain the alignment because good posture contributes to good health. It will also prevent serious damage to the nerves and muscles in the area. It’s possible to keep a healthy spine alignment, whether sitting in the office all day or just having a cup of coffee. All it takes is some thought and conditioning.

Here are some exercises that work great in the office or at home. The goal is to retain the body’s flexibility because it helps with movement. If you develop these habits of stretching early you’ll reap the benefits as you age. You don’t need a set time at work to stretch; you just need to stretch a couple of times during the day. Most of us do experience back or neck pain from sitting all day. The stretches can actually help to reverse the condition and improve your posture.

Common Causes of Healthy Back, Spine and Neck Problems

Today’s lifestyles and work habits can cause back, spine and neck injuries. The most common cause is strain by lifting heavy objects. So can repetitive actions like sitting in the same position for hours. Stretching routines do help to prevent injury and heal the strains.

Easy Stretch Routines Without Leaving the Office

It’s a fact. Neck, back and shoulder pains are associated with a desk-bound job. At some point we all experience strain or stiffness in our neck or back. Simple stretching exercises can prevent muscle strain and restore the body’s flexibility. It helps to loosen up the muscles, increase blood circulation and improve your moods.

1. Sit straight up and raise one arm above your head. Looking forward, bend your arm at the elbow with the palm of your hand touching your shoulder blade. Count to 10. Do the other arm. You’ll feel the stretch in your lower back, the shoulder blade and the upper arm.

2. Sit up straight and bend your head forward. Slowly roll it towards the shoulder, then towards your back and to the opposite shoulder. Finish with a full head roll returning to the starting position. Repeat 5 times. This is a slow movement. Do not pull or strain the neck.

3. Sit upright and cross your right leg. Slowly turn your torso only to the right. Hold the position for a count of 10. Do the same for the left side. You’ll feel the stretch in the mid-section of your body.

Individuals suffering Parkinson’s disease face a number of debilitating motor skills-related symptoms, including stiffness, tremor, rigidity and slowed movement, that affect daily living. For those whose symptoms cannot be controlled solely by medications, deep brain stimulation has potential to serve as an effective additional treatment.

According to the National Parkinson Foundation, deep brain stimulation (DBS) is a widely used surgical procedure that “blocks electrical signals from targeted areas in the brain.” Because the procedure does not destroy nerve cells, it causes no damage to a patient’s healthy brain tissue.

The procedure process

As part of DBS, patients first receive a computed tomography (CT) or magnetic resonance imaging (MRI) scan so the neurosurgeon can locate where within the brain abnormal nerve signals are generating symptoms. In general, the foundation states, the three targeted areas approved by the U.S. Food and Drug Administration for use in PD patients include the sub-thalamic nucleus, the thalamus and a section of the globus pallidus.

During the DBS procedure, the neurosurgeon then implants a neuro-stimulator – a small medical device about the size of a stopwatch that can be programmed externally – in a patient, usually near the collarbone, chest or abdomen. The other parts of the DBS system include the lead (or electrode), a thin, insulated wire implanted in the brain with the tip positioned in the targeted area, and the extension, an insulated wire that connects the lead and the neuro-stimulator.

The three parts of the DBS system then work together to painlessly stimulate the targeted areas of the brain, delivering finely controlled electrical impulses to block the abnormal nerve signals that cause the PD symptoms.

Candidates for DBS treatment

Not all PD patients are suitable for DBS treatment. In general, they must have experienced PD symptoms that interfere with daily activities for at least five years. Additionally, the foundation lists the following as necessary characteristics of candidates wanting to receive the procedure:

Patients have a good response to PD medications – particularly carbidopa/levodopa – even if the response is insufficient.

Patients have tried various combinations of carbidopa/levodopa and dopamine agonists while supervised by a movement disorders neurologist.

Patients have tried other medications (tolcapone, entacapone, amantadine or selegiline) without beneficial results.

When either the globus pallidus or the subthalamic nucleus are targeted, patients generally see a reduction in motor-function symptoms such as rigidity, tremor and bradykinesia. Reducing tremor is the primary function of stimulating the thalamus.

The procedure usually doesn’t help with posture, balance, dementia, depression or anxiety and has not been demonstrated as beneficial for “atypical” parkinsonian syndromes, according to research done by the institute.

Prognosis and side effects

In general, many patients who receive DBS experience “considerable reduction of their PD symptoms and are able to greatly reduce their medications,” according to the foundation. By reducing the medication dose, many patients experience a notable decrease of side effects from levodopa, the most common of which is involuntary movements called dyskinesias.

That being said, most patients remain on prescribed medications after undergoing the procedure.

As with any surgical procedure, DBS can lead to potential complications, which include infection, stroke, cranial bleeding, brain hemorrhage or negative reactions to the anesthesia.

Patients are encouraged to discuss the risks associated with DBS with their neurologist, as underlying medical conditions and other issues can be risk factors, the foundation states.

A computerized tomography (CT) or computerized axial tomography (CAT) scan is a painless, noninvasive diagnostic test that can show organs, bones, tissues, and even blood vessels. Rather than taking an image of one spot, like the traditional x-ray, a CT scan rotates around the patient taking a continuous picture that can be divided up into slices or made into a cross-sectional 3-D image. Because of the CT scan’s ability to show very small bones and the surrounding tissues, these tests are especially helpful in diagnosing spinal issues and injuries to the head and internal organs.

How Do I Prepare for a CT Scan?

This test is an outpatient procedure, and typically doesn’t require much preparation. It’s best to:

Wear comfortable clothes, although you may be required to wear a gown

Remove jewelry, eyeglasses, dentures, pins, and belts

For women, wear a bra without under wire

Check your instructions to see if your test requires you to fast (if your doctor selected a scan with contrast, you may be required to fast a few hours before your test)

What Can I Expect During the Test?

The machine itself is large with a tunnel through it. You’ll be asked to lay on a table that will move slowly through this tunnel. Only the part of your body that is being imaged will actually be in the machine, so most people don’t find the experience claustrophobic.

A technician will be watching you from another room, and have a microphone to communicate with you. If you do become distressed during the test, let the technician know.

You’ll need to be very still as the table moves through the machine. You may be asked to hold your breath at times to minimize movement. The machine may make some whirring and clicking noises as it’s working.

If your doctor ordered contrast, you will need to have iodine dye injected, or barium dye administered orally or through an enema.

The length of the test depends on what needs imaging. A small part of your body may take a few minutes, while a full body scan can take about 30 minutes.

When To Expect Results

After the test is done, it will be sent to a radiologist. The radiologist will examine the scan and write up a report to send to your doctor. Your doctor will call you with the results, typically two to three days after you’ve had the test.

What are the Risks Involved with CT Scans?

There are minimal risks involved with CT scans.

You may have an allergic reaction to the dye that’s used. This can cause mild itching or hives, or you may have trouble breathing if the allergy is severe. In very rare cases, the dye has caused kidney problems.

Women should let their doctor know if they are pregnant. The radiation can harm a fetus.

Radiation exposure is low, and is not considered to be a cause for concern. The extra risk of cancer from being exposed to this ionizing radiation is estimated at 1 in 2000, while the risk of cancer for a U.S. citizen in general is 1 in 5.

It’s important to remember the risk of not getting a correct diagnosis is much greater than the risk of the scan itself. CT scans save lives every day.

Our Doctors Are Here for You

If you have any questions or concerns about an upcoming procedure, please don’t hesitate to reach out. We strive to create a positive experience for you as we help you heal.

What Are Some Recommended Stretches for Relieving Lower Back Pain?
Lower back pain often happens after sprains and strains occur in the complex lumbar region. These muscles, discs and ligaments surrounding the lower part of your spine take on a lot of stress as time goes by. The key to lessening back pain is to integrate both flexibility stretches that bring immediate relief, with muscle-building stretches that work to prevent backaches in the future.

“Get the Kinks Out” Yoga Stretch
A basic “restful pose” followed by a “cat arch” are gentle ways to loosen the knots in your back. Start by getting to your hands and knees on a mat or thick rug.

Move 1: Ease down from the hands-and-knees on the floor position, to one in which your bottom lowers to rest on your feet; your torso lowers, stretching forward; and your arms extend forward, as if in a dive. Stay in this position for a count of 20, if you can. After slowly sitting up and resting, repeat the move two or three more times.

Move 2: Return to your hands-and-knees position on the mat, in a squared-off position — hands braced on the floor parallel to your shoulders, and knees positioned just below your hips.

Arch you back like a cat as you breathe out, tightening your stomach as you do so. Hold the pose for at least five seconds, then breathe in while rounding your back, again for five seconds. Repeat this sequence for a total of 10 cycles through the arched back, then rounded back, cycle.

“Build the Back” Crossover Stretch
To lengthen a key muscle in your lower back affecting the lumbar region and legs (the piriformis muscle), start by sitting down on a bed or other comfortable surface, with your right leg bent so that your foot rests up against your bottom — so that you are “cross-legged” on side.

Next, cross your left leg up and over the bent right leg, and bend it so that your left knee is facing the ceiling, with your left foot resting against your right thigh. Rest your hand on the floor for stability, and twist your torso in that direction, while stretching your spine. Hold this pose for up to 20 seconds, then reverse the position and repeat the twitch-stretch move in the opposite direction. Repeat the sequence two or three more times.

“Stretch the Core” Physioball Moves
Sitting on a large exercise ball is ideal for the times when your back is hurting too much to lie down on a mat. A physioball is no more difficult to get on or off than a chair, yet provides some great spine stretching, core-building exercise.

Move 1: Sit on the ball with your hands on your hips. “Suck in” your abdominal muscles, and hold this position for about five seconds. Repeat at least 10 times.

Move 2: Remain seated with your hands on your hips. Again, “suck in” your abdominal muscles as in Move 1, but this time raise one knee as if you were “marching” while sitting, and hold your leg in that position for about five seconds. Lower your leg and repeat with your opposite knee. Alternate this move at least 10 times.

Tips
If you can, do these stretches just before bed, in order to work out soreness from the day and promote healthy sleep. An application of an ice pack several minutes before stretching may further enhance flexibility and ease pain.

Of course, lower back pain can stem from undiagnosed illnesses and forgotten injury. It’s best to check with a healthcare professional in case additional treatment is needed.

What is Long Term Acute Care?

Long term acute care is defined as medical care provided to patients who require ongoing hospitalization for a longer period of time than typically provided in a general acute care hospital. The average length of stay varies by patient medical need.

What Types of Patients are Appropriate for Long Term Acute Care (list is not all-inclusive)?

Patients requiring long term acute care require access to a high acuity healthcare model with 24/7 onsite physicians, medical/surgical experienced nursing staff, respiratory therapists, laboratory, pharmacy, radiology, rehabilitation department and an ICU. Skilled and nursing home care is limited in the range and frequency of services provided and is more nursing oriented with monthly physician visits.

How Often Do Physicians Round on Patients? Daily

What makes Long Term Acute Care so unique for the Healing Process?

A transdisciplinary care approach is utilized to provide simultaneous acute medical care and therapy services during the patient’s recovery. This approach drastically reduces long-term setbacks due to the catastrophic illnesses that patients are suffering from and achieves shorter recovery times. The transdisciplinary team focuses on the individual needs of each patient, conducts ongoing team conferences, and is directed by a physician and includes nursing, case management, pharmacy, nutritional services, rehab therapy, social and psychological services. Patients and their family members are important members of the care team, and are encouraged to participate in all aspects of the patient’s care.

How are Patients Referred to a Long Term Acute Care Hospital?

Patients can be referred by physicians, social workers, case managers, patient care givers and family members. Intake coordinators at the hospital are available to facilitate the admission process. Clinical nurse liaisons in the field interact directly with patients and referral sources to ensure a safe and efficient transition of care from the previous clinical setting.

As technology continues its exponential development, medical procedures have reaped the benefits. Surgical procedures are becoming less invasive, requiring less recovery time and imposing less risk to patients and practitioners alike.

Spinal surgical procedures are no different, also benefiting from recent developments. Minimally invasive spinal surgery takes advantage of technology in a couple of ways.

Robotic surgery uses computers and mechanics in combination. The surgeon controls robotic arms with precision using computer software to guide the arms during the procedure.

Minimally invasive surgical techniques

Endoscopic surgery involves the surgeon employing a camera lodged inside a flexible tube. The tube is inserted into the body via an existing orifice like the nose or mouth or, in the case of spinal surgery, through a small incision into the body. The surgeon will watch the procedure on a computer monitor, but will use his or her experienced hands to perform the procedure.

When spinal surgeons use endoscopic surgery, they make two small incisions, one for the scope and another to allow the surgeon to work on the spine. The surgeon will move the muscles aside to reach the spine. The muscles won’t have to be sliced because of the surgery.

These minimally invasive procedures have several benefits for spinal surgery patients.

With both robotic and endoscopic surgery, patients will experience smaller incisions.

There will be less pain for patients upon awakening.

In the case of spinal surgery, older techniques often required a large incision held open by clamps. This increased the risk of infection. With minimally invasive surgery, there is much less worry of infection.

Hospital stays are shorter with minimally invasive procedures.

The smaller incision reduces recovery time for patients.

There is less blood loss during surgery.

The patient will experience reduced scarring post-surgery.

Laser surgery

When people hear the term “laser surgery,” it’s easy to think that laser surgery is a completely different kind of surgery than minimally invasive surgery. We associate lasers with high-tech, futuristic gadgets. However, in medicine, the future is now.

Lasers are a tool in surgery. Laser surgery simply notes that the surgeon is using lasers instead of the traditional scalpel. Lasers make the cuts by vaporizing soft tissue. With lasers, a surgeon can make small, precise cuts that heal easily. The surgeon will still have to make an incision into the body to insert the laser. Then the laser will cut away soft tissue. The spinal surgeon will still employ other surgical tools during the operation.

In spinal surgery, some physicians believe the laser helps them make more precise cuts than when using a scalpel. Some surgeons believe that the scalpel is the tool to use.

The difference between laser surgery and minimally invasive surgery

So then, laser surgery is a kind of minimally invasive surgery. Some surgeons will use a laser along with other techniques to deliver minimally invasive care to the patient. To the patient, it’s most important that the surgeon use minimally invasive techniques. It is up to the surgeon as to whether to use lasers or scalpels if they are skilled in using both. The goal is to create the best surgical experience for the patient using surgical techniques that produce the best outcome.

Skilled surgeons like those at the Colorado Brain and Spine Institute have the knowledge, skill and experience to determine what procedures are best for your medical issue. When surgery is on the table, trust us to provide the best available care; compassionate pre and post-surgery attention and precise, thorough care during the procedure.

A certain degree of scarring is inevitable with virtually any sort of surgical procedure. In some cases the scar may be so small that it won’t be easily detected to either the eye or by touch. Your surgeon may also be able to place the incision site in an unobtrusive spot or in a location that can be easily covered by clothing or your hair.

In some cases, however, you could be left with a scar that you find unsightly and distressing. The good news is that there are many different preventive techniques and treatments that can greatly improve the condition of a post operational scar. Some of these methods may be used before surgery or at the earliest stages while the incision area is still healing. Other treatments can also be done later to alter or revise the appearance of a mature scar.

Who’s At the Greatest Risk for Scars?

Skin color, age, lifestyle, and genetics all play a role in how likely your skin will form visible scars. Generally speaking, the younger and healthier a patient is, the more likely it is that they have thicker and more resilient skin. Thicker skin has more collagen in it which makes it more elastic and therefore it’s able to “bounce back” after injury better.

Scars, at least in the early stages when they are still pink, are more visible on people with lighter skin tones. On the other hand, some races are genetically more likely to form thicker scars that are raised from the skin’s surface.

Smoking and tanning have a very negative effect on both how quickly a scar heals and how visible it is. Tanning will darken a scar, making it more visible in contrast against the surrounding skin. Smoking is particularly damaging to skin quality. It can delay healing by lowering vitamin levels, adding contaminants to the bloodstream, and increasing the chance of complications like infections.

Scar Prevention

Talk with your surgeon about possible ways that he can minimize scarring. He may be able to use a special type of silicone dressing that’s known to improve scar appearance. There may also be certain ointments or creams that you can apply to the area before surgery.

In some cases, steroid injections can help reduce the chance of your skin forming keloid scars. Dark, raised keloid scars can happen to all skin types but are more common with people of Hispanic or African heritage.

Post Surgery Scar Treatments

There are numerous commercial products available that claim to reduce the appearance of scars. Some of these work better than others, so be sure to ask your surgeon for his recommendations. You can also speak with a dermatologist if you have an older scar that you’d like to change.

Maintaining a healthy lifestyle and body weight will also improve how quickly and completely your scar fades. Alcohol and caffeine dehydrate the skin, which will slow healing and can cause existing scars to look worse. If you smoke, most surgeons will recommend that you abstain completely for at least the first two weeks after surgery. Also limit the amount of sun exposure that the area receives. Ask your doctor when it’s safe for you to apply sunblock to the scar and try to keep the area covered until then.

In certain cases it’s also possible to have a scar revision treatment. Sometimes this is done surgically if the scar is unusually thick. Lasers can also be used to soften and fade the appearance of scars, although there are certain risks involved and not every skin type is a candidate.

Improper lifting technique is a major cause of back pain, especially among people who must routinely lift heavy objects on the job. This is because most stress from lifting centers in on the lower back. Proper body mechanics shifts this stress from the vulnerable back to the much stronger and more resilient leg muscles.

The object of body mechanics is to maintain balance and control at all times. In addition to preventing injuries, lifting the right way also conserves energy. This means reducing strain so you won’t tire out as quickly. We hope that these tips will help improve safety and efficiency when picking up heavy objects, whether at work or on moving day.

The Right Way to Lift

Start by testing the load. Grip the object to estimate its weight. An object that is heavier than expected is more likely to cause stress. You should also determine whether or not the weight is equally distributed. Lifting uneven loads are especially bad for the back. When lifting an unevenly packed box, rearrange the items inside if possible.

Face the object. Stay facing the object while picking up and carrying it. Twisting the spine under stress can cause injury.

Keep your feet apart. Don’t do the splits, but try to position your feet so that they line up with your shoulders. This helps create a stronger foundation with your legs and avoids concentrating stress along your spine.

Always use slow, smooth movements. Jerky movements are more likely to result in muscle strain and back injury. Likewise, try to work slowly at a steady pace that feels right for you. Rushing also increases the risk of injury.

Bend your knees and enter a squatting position. This is part of “lifting with your legs.”

Stand up. From the squatting position, grip the object and stand up. Make sure to keep your back straight the entire time. The stress from the load should be concentrated in your legs and arms.

Keep the object close to your body. Once upright, bring the item you’re lifting as close to your torso as possible. Keep the object close while carrying it.

Never lift a heavy object above shoulder level. Raising a load too high significantly increases the risk of injury to your spine and also introduces the possibility of a dangerous head injury. Keeping heavy objects between your shoulders and waist is ideal.

Take regular breaks. When you’re lifting many items, be sure to stop and take a break for a few minutes whenever you can. Taking breaks reduces muscle strain and is especially important for preventing back strain.

Get someone to help when possible. Proper body mechanics doesn’t eliminate stress, strain, and potential injury completely. If you need to lift an item that you think may be too much for one person, ask a friend or coworker for help. A second person is also a good idea for even lighter loads. Reducing the amount of stress always helps to prevent back strain.

Dealing With Back Pain

While it’s better to prevent back injuries before they happen through proper body mechanics, lower back pain can be treated. If you’re experiencing back pain or other spine-related problems, contact us at the Colorado Brain and Spine Institute to find out if treatment is right for you.

When you’re experiencing chronic back pain, the thought of having spine surgery may seem scary. Surgical procedures come with risks, and you may be worried about undergoing a surgical procedure. You may be surprised to find that many patients never need surgical intervention to enjoy pain relief. However, when conservative options don’t work, it’s important to know when surgery is the right step in your search for a pain free back.

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Consulting with a Spine Specialist

The best way to determine what type of treatment is necessary for your back pain is to consult with a spine specialist. A specialist can diagnose the cause of your symptoms and pain with the use of medical imaging and other tests. After determining the source of the spine pain, then your specialist can offer treatment recommendations, helping you to determine the next step. In most cases, spine surgery will not be the first treatment recommended.

Exhaust Conservative Treatment Options First

When you’re considering surgical intervention, it’s always a good idea to exhaust more conservative treatment options first. Some conservative treatment therapies that offer excellent results for many patients include injection therapy, medication therapy, and physical therapy. Most patients will find success with more conservative treatments, but if you continue to experience pain and/or other symptoms after treatment, it’s important to bring this to the attention of your spine specialist.

When Does Spine Surgery Become Necessary?

In some cases, damage or injury to the spine may require spine surgery, particularly if you’ve exhausted conservative treatment options with no relief. If you’re still experiencing significant pain or dealing with other symptoms that affect your quality of life, it may be time to consider the next step – surgery. However, surgical intervention should always be considered a last resort.

Surgery may become necessary to treat back pain that results from many sources, including:

If your specialist recommends surgery and you’re unsure whether it’s the right step for you, you can always get a second opinion. Quality, qualified surgeons will be happy to have you get a second opinion, since they understand that undergoing surgery on your spine is a big step in your pursuit of a pain free back.

The Benefits of Minimally Invasive Spine Surgery

When you and your spine specialist decide that spine surgery is the right next step for your unique case, talk to the surgeon about your surgical options. Many minimally invasive techniques are now available, and these techniques increase the safety and outcomes of surgical intervention. Minimally invasive surgery also reduces recovery times, ensuring you get back on your feet quickly. You’ll enjoy fewer risks and a great chance of success with these cutting-edge, minimally invasive techniques are used by your spinal surgeon.

Although surgical intervention is rarely the first treatment option to consider, it can help you finally enjoy a pain free back if other treatments have failed. Talk to your spine specialist today to find out if surgery is a viable treatment option for your back pain.

Spinal surgery is usually only considered after more conservative treatment methods like physical therapy and medications have already been tried. This is because surgery of the spine can be very risky, with even minor errors creating serious problems for the patient. For this reason, spinal surgery requires an especially high level of instrument positioning and control. The surgeon must also have access to the part of the spine that needs to be corrected. Traditional open spine surgery requires an incision large enough to expose the entire surgical site. Larger incisions are associated with greater tissue damage and more severe postoperative pain.

Robot-Assisted Minimally Invasive Surgery

Over the last few years, new developments in minimally invasive spinal surgery have sought to fix these problems. In minimally invasive surgery, a tiny endoscope—a flexible tube with a light and camera on one end often accompanied by a surgical tool—is inserted through a very small incision near the area of the spine to be operated upon. The surgeon must then navigate the tool to the problem area itself, avoiding major blood vessels, nerves, and other important internal structures.

Now, spinal surgeons are using even more advanced three-dimensional image-guided therapy to further improve upon minimally invasive spinal surgery techniques. Image-guided therapy includes all medical procedures that use generated pictures to target a medically relevant site. What started with the x-ray in the 19th century has now merged with the world of robotics.

These robot-assisted surgeries are planned with the aid of specialized software long before the first incision. The surgeon uploads a CT scan of the patient into the robotic system’s 3D-planning software. The surgeon then uses these highly accurate 3D images to plan out the surgery in detail. Once surgery begins, the surgeon then uses the system to help guide his or her hand to complete what was mapped out in the planning stage. In addition to navigation, these systems also reduce even minor tremors for greatly improved dexterity.

Benefits of Robotic Navigation

While these robot-assisted systems may be new to most surgical practices, years of research have revealed many advantages over traditional surgery:

Accuracy improved by up to 70%.

Greater consistency with screw placement.

Reduced chance of complications.

Less pain.

Minimal tissue damage thanks to smaller incisions and better accuracy. One dramatic example found significant medial breach to be eight times more likely to happen without robotic navigation. Another is that only 0.6% of screws placed with the aid of robotic navigation had to be removed during surgery compared to 4.9% in traditional surgery.

Better outcomes for complicated cases. Many spinal surgeries are performed on tissue that is distorted from problems like scoliosis or bone-destroying tumors. Direct real-time imaging is especially important when treating patients with these issues.

Reduces radiation exposure by 56%. Traditional spinal surgery requires a large number of x-rays to compensate for the lack of direct imaging.

Faster recovery time. Patients undergoing robot-assisted spinal surgery spent an average of 27% less time in the hospital.

Experienced Spinal Surgeons

One thing to keep in mind about spinal surgery with robotic navigation is that it in no way replaces the need for an experienced spinal surgeon to perform the procedure. Robotic navigation systems can only make skilled surgeons even better. If you’re considering spinal surgery or other related treatments, consider contacting us at the Colorado Brain & Spine Institute.